Lymphatic drainage is usually to the tonsillar lymph node behind the angle of the mandible, or to other jugulodigastric lymph nodes. Venous drainage occurs through a venous peritonsillar plexus that drains into the lingual and pharyngeal veins and feeds into the internal jugular vein. The capsule is adjacent to the superior constrictor muscle of the pharynx and the stylopharyngeus muscle laterally 12. The large structures on the lateral aspect of the pharynx are the tonsils. The superior pole receives its blood supply from the ascending pharyngeal artery and from the lesser palatine artery. The lateral aspect of the palatine tonsils in the tonsillar fossa is surrounded by a tough fibrous capsule, which represents the extension of the pharyngeal aponeurosis. The arterial blood supply is primarily based at the inferior pole, and the tonsillar branch of the dorsal lingual artery, the ascending branch of the palatine artery, and the tonsillar branch of the facial artery enter at this site. The descending branches of the lesser palatine nerve are another sensory supply to the tonsil. The tympanic branch of glossopharyngeal nerve is responsible for a referred otalgia that is commonly present with tonsillar inflammation or following tonsillar surgery. Adenoid tissue is lymphoid tissue located midline in the nasopharynx. The glossopharyngeal nerve lies deep to the superior pharyngeal constrictor and supplies sensation to the tonsil through the tonsillar branch. The tonsillar bed is formed by the superior constrictor muscle of the pharynx.
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